Cargando…
Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic
OBJECTIVE: During the COVID-19 pandemic, community health workers (CHWs) served as front-line workers in the COVID-19 response while maintaining community health services. We aimed to understand challenges faced by Rwanda’s CHWs during a nationwide COVID-19 lockdown that occurred between March and M...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058292/ https://www.ncbi.nlm.nih.gov/pubmed/35487742 http://dx.doi.org/10.1136/bmjopen-2021-055119 |
_version_ | 1784698081152860160 |
---|---|
author | Niyigena, Anne Girukubonye, Ignace Barnhart, Dale A Cubaka, Vincent K Niyigena, Pierre Celestin Nshunguyabahizi, Marcel Mukamana, Beatrice Kateera, Fredrick Bitalabeho, Florence A |
author_facet | Niyigena, Anne Girukubonye, Ignace Barnhart, Dale A Cubaka, Vincent K Niyigena, Pierre Celestin Nshunguyabahizi, Marcel Mukamana, Beatrice Kateera, Fredrick Bitalabeho, Florence A |
author_sort | Niyigena, Anne |
collection | PubMed |
description | OBJECTIVE: During the COVID-19 pandemic, community health workers (CHWs) served as front-line workers in the COVID-19 response while maintaining community health services. We aimed to understand challenges faced by Rwanda’s CHWs during a nationwide COVID-19 lockdown that occurred between March and May 2020 by assessing the availability of trainings, supplies and supervision while exploring perceived needs and challenges. DESIGN AND SETTING: This study was a mixed-method study conducted in three Rwandan districts: Burera, Kirehe and Kayonza. MAIN OUTCOME AND MEASURE: Using data collected via telephone, we assessed the availability of trainings, supplies and supervision during the first national lockdown, while exploring perceived needs and challenges of CHWs who were engaged in COVID-19 response, in addition to their existing duties of delivering health services in the community. RESULTS: Among the 292 quantitative survey participants, CHWs were responsible for a median of 55 households (IQR: 42–79) and visited a median of 30 households (IQR: 11–52) in the month prior to the survey (July 2020). In the previous 12 months, only 164 (56.2%) CHWs reported being trained on any health topic. Gaps in supply availability, particularly for commodities, existed at the start of the lockdown and worsened over the course of the lockdown. Supervision during the lockdown was low, with nearly 10% of CHWs never receiving supervision and only 24% receiving at least three supervision visits during the 3-month lockdown. In qualitative interviews, CHWs additionally described increases in workload, lack of personal protective equipment and COVID-specific training, fear of COVID-19, and difficult working conditions. CONCLUSION: Many challenges faced by CHWs during the lockdown predated COVID-19 and persisted or were exacerbated during the pandemic. To promote the resilience of Rwanda’s CHW system, we recommend increased access to PPE; investment in training, supervision and supply chain management; and financial compensation for CHWs. |
format | Online Article Text |
id | pubmed-9058292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-90582922022-05-06 Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic Niyigena, Anne Girukubonye, Ignace Barnhart, Dale A Cubaka, Vincent K Niyigena, Pierre Celestin Nshunguyabahizi, Marcel Mukamana, Beatrice Kateera, Fredrick Bitalabeho, Florence A BMJ Open Public Health OBJECTIVE: During the COVID-19 pandemic, community health workers (CHWs) served as front-line workers in the COVID-19 response while maintaining community health services. We aimed to understand challenges faced by Rwanda’s CHWs during a nationwide COVID-19 lockdown that occurred between March and May 2020 by assessing the availability of trainings, supplies and supervision while exploring perceived needs and challenges. DESIGN AND SETTING: This study was a mixed-method study conducted in three Rwandan districts: Burera, Kirehe and Kayonza. MAIN OUTCOME AND MEASURE: Using data collected via telephone, we assessed the availability of trainings, supplies and supervision during the first national lockdown, while exploring perceived needs and challenges of CHWs who were engaged in COVID-19 response, in addition to their existing duties of delivering health services in the community. RESULTS: Among the 292 quantitative survey participants, CHWs were responsible for a median of 55 households (IQR: 42–79) and visited a median of 30 households (IQR: 11–52) in the month prior to the survey (July 2020). In the previous 12 months, only 164 (56.2%) CHWs reported being trained on any health topic. Gaps in supply availability, particularly for commodities, existed at the start of the lockdown and worsened over the course of the lockdown. Supervision during the lockdown was low, with nearly 10% of CHWs never receiving supervision and only 24% receiving at least three supervision visits during the 3-month lockdown. In qualitative interviews, CHWs additionally described increases in workload, lack of personal protective equipment and COVID-specific training, fear of COVID-19, and difficult working conditions. CONCLUSION: Many challenges faced by CHWs during the lockdown predated COVID-19 and persisted or were exacerbated during the pandemic. To promote the resilience of Rwanda’s CHW system, we recommend increased access to PPE; investment in training, supervision and supply chain management; and financial compensation for CHWs. BMJ Publishing Group 2022-04-29 /pmc/articles/PMC9058292/ /pubmed/35487742 http://dx.doi.org/10.1136/bmjopen-2021-055119 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Public Health Niyigena, Anne Girukubonye, Ignace Barnhart, Dale A Cubaka, Vincent K Niyigena, Pierre Celestin Nshunguyabahizi, Marcel Mukamana, Beatrice Kateera, Fredrick Bitalabeho, Florence A Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title | Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title_full | Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title_fullStr | Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title_full_unstemmed | Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title_short | Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic |
title_sort | rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during covid-19 pandemic |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9058292/ https://www.ncbi.nlm.nih.gov/pubmed/35487742 http://dx.doi.org/10.1136/bmjopen-2021-055119 |
work_keys_str_mv | AT niyigenaanne rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT girukubonyeignace rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT barnhartdalea rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT cubakavincentk rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT niyigenapierrecelestin rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT nshunguyabahizimarcel rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT mukamanabeatrice rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT kateerafredrick rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic AT bitalabehoflorencea rwandascommunityhealthworkersatthefrontlineamixedmethodstudyonperceivedneedsandchallengesforcommunitybasedhealthcaredeliveryduringcovid19pandemic |